Real-time monitoring of bladder activity is essential for assessing and diagnosing lower urinary tract dysfunction. However, traditional clinical monitoring methods that rely on repeatedly invasive catheters can cause considerable physical and psychological discomfort for patients. In this study, we present a tissue-like implantable sensor that enables real-time bladder activity monitoring while eliminating the need for repeated invasive procedures. The sensor incorporates a tissue-like antifouling, self-healing, and biodegradable zwitterionic elastomer through strategic molecular integration of soft and hard segments with various dynamic bonds in a supramolecular polymeric framework. In addition, the study explores the relationship between molecular structure and self-healing performance, revealing that the presence of degradable molecules enhances self-healing efficiency to ∼95.4 %. Using the elastomer substrate, we develop a pyramidal microstructure-based sensor that achieves a fivefold increase in sensitivity. Both in vitro and in vivo studies demonstrate the sensor's biocompatibility and reliable monitoring performance during long-term implantation. The sensor degrades naturally in ∼34 weeks, eliminating the need for its secondary surgical removal. This work offers a novel solution for real-time in vivo monitoring, facilitating intelligent diagnosis of various diseases and benefiting patients.